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Inconsistent Billing Causes Patients to Find New Providers

THERE IS A NEW SOURCE OF LOST BUSINESS for physicians, clinical laboratories, and others. Patients are losing patience with confusing bills from their providers and opting to find new providers who offer simple, clear, and consistent bills. This turnover in patients was one key finding in a recently-…

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June 18, 2018 Intelligence: Late Breaking Lab News

In New Jersey last week, David Nicoll, 44, the former owner of Biodiagnostic Laboratory Services (BLS) of Parsippany, N.J. was sentenced to 72 months in a federal prison. On the same day, his brother, Scott Nicoll, 37, who also worked at BLS, was sentenced to 43 months in prison. Bo…

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How Many Patients Were Harmed at Theranos?

CEO SUMMARY: Reporting in The Wall Street Journal shows that some physicians in Arizona were concerned about the harm from erroneous test results from Theranos Inc. But those physicians who expressed concern may have been only a small set of the …

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Lab companies and bankrupt hospitals: Dancing around medical billing fraud

This is an excerpt from a 2,000-word article in the May 29, 2018 issue of THE DARK REPORT. The complete article is to all readers as long as the article limit has not been reached, and always available to paid members of the Dark Intelligence Group. …

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Why Lab Companies Buy Bankrupt Rural Hospitals

CEO SUMMARY: Seeking the higher lab-test payment rates that insurers pay hospital labs, some lab testing companies are buying rural, financially-struggling hospitals in what may be the latest twist on the pass-through billing strategy that certain lab testing firms have found to be lucrat…

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Did National Labs Sign Value-based Payer Contracts?

IT IS AN IMPORTANT SIGN OF THE TIMES when press releases about the two new national lab services agreements that UnitedHealthcare just announced with Laboratory Corporation of America and Quest Diagnostics emphasize how value-based programs will be a…

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Insurers Sue To Challenge Pass-Through Bill Schemes

CEO SUMMARY: In two separate lawsuits filed in April, UnitedHealthcare (UHC) and Anthem each charged that drug testing companies used pass-through-billing schemes in ways the insurers say are fraudulent. UHC filed its lawsuit on April 18. One day later, on April 19, Blue Cross and Blue Sh…

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Discovery of Pathology Errors Shows Quality Flaws

MOST PATHOLOGISTS WOULD AGREE THAT PATIENTS AND THEIR PHYSICIANS have every right to expect a timely, accurate lab test result. Stated differently, patients and physicians implicitly trust that a pa…

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Legal Briefs Explain Problems with PAMA Implementation

CEO SUMMARY: Several developments have moved the case forward since December when the American Clinical Laboratory Association filed suit in federal court against the Department of Health and Human Services. Inrecent weeks, ACLA filed for summary judgment; HHS responded with its own reque…

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Response to FDA’s Gottlieb on Reducing Regulatory Burden

IN PREPARED REMARKS at a clinical lab industry meeting last month, FDA Commissioner Scott Gottlieb, MD, outlined steps the federal Food and Drug Administration would take to reduce the regulatory burden on labs that develop next-generation gene sequencing and lab-developed tests. He …

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